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STDs  (Expert Forum)
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after (pre-)/ cancer treatment, still hpv contageous?
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

after (pre-)/ cancer treatment, still hpv contageous?

by beatbox, Feb 23, 2009 05:54PM
After a woman gets treatment for cervical cancer (i think she had to do chemo-, or at least was treated for pre-cancerous cells), can she still infect a male with HPV?

I started seeing a woman a couple months ago and the first time we had sex, she had some vaginal bleeding.  we didn't think too much about it (or at least I didn't), but it took some time to get a pap smear and an hpv test done.  An abnormal biopsy showed the presence of HPV (strain 52, which is one of the high risk types).

1. Since there was bleeding the first (and subsequent) time(s) we had sex,  she had cervical cancer before, and there is a latency period, does it make it most likely it came from her and not me?
It's not a blame thing.  It matters because if I know it came from her, it changes the people i would need to inform.
She didn't tell me any of the back story until the results came back.  

2. Re #1, I know in the forum some suggest that there's no need to inform future partners,
is that still the advice knowing that it is a strain that led to a cancerous outcome?

3. And should I be upset that she didn't mention any of this to me until the results of the pap smear/hpv test came back, given her previously known condition?  we had sex at least a few times w/o a condom.

4. From what i've read, i can't determine if i have it or can pass it on.  is my chance for penile cancer any higher?

Any help would be appreciated.

by Edward W Hook, MD, Feb 23, 2009 06:21PM
Let's start with more accurate statements.  "High risk" HPV and abnormal Pap smears are not cancer.  Most people (men or women) who get such infections clear them by themselves with no therapy.  People who have cervical cancer do not transmit cervical cancer.  Some may transmit HPV but this is just not a big deal.  Close to 90% of Americans will get HPV, often more than once, during their lives and of those, only a small fraction will have problems due to the infection.  As for your questions:

1.  I am not sure of the question. Are you asking if you might have given her the HPV that lead to the abnormal Pap?   If so, the answer is probably not.  If you are asking if she might have given you an HPV infection, the answer is maybe.  There is no way to know.

2.  Yes the answer is generalizable to all HPV types.  If a person KNOWS they have HPV, the right thing to do is to tell recent prior partners.  That's just a civility issue.  Hopefully those partners can handle the result and not worry.  Knowing who gave HPV to whom or how long someone has had it however is a can of worms.  

3.  If you do not have a visible lesion, I would urge you not to worry.  Should you get a visible lesion, get it checked.  The odds of you getting penile cancer are so low as to hardly be worth mentioning

Hope this helps.  EWH
Member Comments (3)

by beatbox, Feb 23, 2009 07:12PM
To: doc
Thanks.  I think I understand.

1.   For future reference.  Given 99%+ of cervical cancer is caused by HPV.  If someone tells me they had been treated for cervical cancer in the past, should I have equated that to a high chance of them transmitting HPV to me now?   Is the past infection still relevant after they've been treated?

2.    If a person who had a previous cancer diagnosis and HPV infection discovered vaginal bleeding during intercourse and was concerned enough to have it checked out, would I be right in assuming that it'd at least be common courtesy to mention the possibility of infection to me and to stop having unprotected sex while it was being checked out?    Or is it not obvious or so 'not a big deal', that the general recommendation is not tell the partner until it is confirmed?

3.   My worry is lowered.  Can you clarify your #2 response?  Should I assume that I KNOW I have HPV and tell future partners?  or only assume i've merely been exposed to it until some other fact says otherwise?

Thank you!

by Edward W Hook, MD, Feb 23, 2009 10:02PM
One more time, it appears that your partner had HPV and perhaps Pap smear changes related to this infection, NOT cervical cancer.  If you have ever had sex before you were withthis partner, you probably have and/or have had HPV as well.  It is not a big deal.

1.  No, HPV is a precursor to cervical cancer.  The cancer is not HPV and connot be transmitted.  A person cannot catch the HPV that casues cervical cancer after it has been successfully treated.

2.  No, you are incorrect.  There are many other casues of bleeding other than cervical cancer.  In fact cervical cancer does not bleed until it is in a very advanced stage.  

3.  You don't even know that you were exposed to HPV and from what you've told me, there is no evidence that you do.  I see nothing to tell partners about in your case.

Despite your statements to the contrary, your questions and the tone they take suggest that either you are very afraid of having caught something from your partner and./or looking for someone to blame for something.  She is the one who needs to be worried, not you.  EWH
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